MGMA In Practice Blog

September 3, 2009

It's back to school time, and parents may be visiting your medical practice with forms to be completed and signed by their children's physician. Are you giving away this service for free? Should you? Depending on your practice's philosophy, you may want to rethink your policy on patient forms.

Paperwork from schools, camps, the Family Medical Leave Act (FMLA) workers' compensation claims take up valuable physician time – which can turn into uncompensated physician time. Even nominal fees for completing patient forms can help justify time spent and bring in extra cash.

When can you charge?

There's a large gray area when it comes to charging for forms, so check your payer contracts. If a payer includes form completion with payment for other covered services, you can't charge extra. If the form is unrelated to the billed service, you can bill the patient for filling it out – in some circumstances. But even if you can't charge, a good coder will ensure that the physician's time spent filling out forms is appropriately reimbursed.

How much should you charge?

MGMA members weighed in on the question in the MGMA Member Community. While many practices and physicians charge anywhere from $5 to $55, most say they base their rate on the quality of service they give the patient – and how much time they spend on form completion.

Several administrators said that their practices complete the first form per patient for free, then charge $10 per subsequent form. One admitted to completing these forms herself, rather than bothering the doctors. Other comments we collected concerning patient forms:

"We evaluated this $10 or $12 thing and learned it wouldn't even pay for the staff time. So, we recently changed to $25 processing fee PLUS $5/page. Therefore, for example, an FMLA is $45."

"We require the patient make an appointment to go over the form with the physician. This way it's not uncompensated time and... medical questions that have not been covered by the patient/physician in recent time... can be [answered] during the visit."

"We charge $5 per page and cap at $25. It has cut down on patients bringing in copies of forms that they 'lost' and need us to fill out again."

"For FMLA and disability forms, we charge $35 plus $5 per side of paper. So, a four-page FMLA form is $55, paid in advance."

"It depends on the kind of form or letter that is needed. If it is a disability form, we require an appointment to go over the diagnosis (reason for disability) to best answer the questions. We fill out the form as part of the exam. Therefore, the charge is for the visit, not the form. We do the same for FMLA."

Do you charge for patient forms?Tell us your strategy in the comments.

It's outrageous for doctors to charge anything for signing a basic and common form. For example, my father-in-law's doctor charged $25 to get his John Hancock on a DMV application for a handicap placard. What the heck is that about? What "service" did the doctor perform that s/he didn't already do during the regular exam? It's shameful for doctors to be looking at their patients as cash cows.